More adolescents arriving in ERs for opioid abuse; risk of addiction averages 50 times higher for youths after surgery

October 11, 2017
By
Novus Medical Detox Center

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A study of nearly 90,000 pediatric patients, ages 13 to 21 years, has found
that new, persistent opioid use following surgery “may represent
a significant pathway to nonmedical opioid use among adolescents.”
In fact, compared to a control group of non-drug-using, non-operative
13-to-21-year-olds, the surgery group averaged 50 times more likely to
become habitual opioid users after discharge from hospital. Recent studies
have demonstrated that postoperative use of opioids presents an important
risk factor for new opioid dependence, said Calista Harbaugh, MD, of the
University of Michigan. This first-of-its-kind study investigated new
opioid use among “opioid-naïve” adolescents after surgery.
From 2010 to 2015, the surgical cohort of 88,637 young patients underwent
one of 13 common surgeries. None had any history of prior opioid prescriptions.
The surgical patients were a mean age of 17 years, and the incidence of
new, persistent opioid use following surgery was 5 percent, compared to
only 0.1 percent among the non-operative control group. Continued opioid
use ranged from 2.7 percent to 15.2 percent across the different surgeries,
yielding a mathematical range of increased risks of from 27 times to 152
times, depending on the surgical procedure. Surgeries associated with
the highest risk of new opioid use were cholecystectomy – removal
of the gall bladder – and colectomy – removal of part of or
the entire colon. Other risk factors independently associated with new
persistent opioid use included older age, being a girl, higher comorbidity,
anxiety, and pre-existing drug and substance use. “Identifying alternative
methods of perioperative pain management for this population should be
a priority,” Harbaugh concluded.

More kids in ER for opioids

In a related study, researchers at the University of Iowa have expanded
the current national estimates of opioid abuse by children and adolescents.
The study has found a significant increase during the period from 2008
to 2013 in the number of emergency department (ED) visits by children
for opioid abuse or dependence. The number of ED visits that included
codes for opioid abuse or dependence rose from over 33,000 visits in 2008
to nearly 50,000 in 2013. Veerajalandhar Allareddy, MD, and colleagues
at the Stead Family Children's Hospital in Iowa City, said, “We
sought to estimate the burden of opioid dependence/abuse (OD/OA) in children
who visited the emergency department for any cause in the United States.”
The study found 250,000 ED visits across the country among children up
to age 21 for opioid abuse or dependence. Nearly 90 percent of the visits
were by patients ages 18 to 21 years old, with only 8 percent among those
aged 16 to 17 years. More than half – 56 percent – were boys.
Some 200 kids died in EDs, and 325 died following hospitalization. The
most common diagnostic codes were “Unspecified” opioid abuse
and opioid dependence. The study also looked at the average costs of the
ER and hospitalization admissions for the study period. Mean ED charges
were roughly $2,300, totaling $505 million. Hospitalization costs were
over $23,000, totaling $2 billion. Younger patients, defined as 9 or under,
and patients with heavy comorbidities, as well as those from higher income
households, were “more likely to be hospitalized as opposed to being
routinely discharged from the ED. The uninsured were less likely to be
hospitalized,” the study said. If you or someone you know has adolescent
children who might be exposed to drugs, take the time to help get some
dialog going with them about the dangers kids are facing today. And if
you or someone you care about has a substance use problem, don’t
hesitate to call Novus right away.

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